Airway-Facially Generated Treatment Planning (AFGTP) in Complex Anterior Open-Bite Cases Integrating Airway Screening, FGTP, Aligner Therapy, and Skeletal Anchorage.

Complex anterior open-bite malocclusions require a holistic, risk-stratified approach that extends beyond dental alignment to address the airway, facial form, function, biomechanics, and periodontium. This article outlines a contemporary airway-facially generated treatment planning (AFGTP) protocol that begins with airway screening and dentofacial analysis, incorporates functional and biomechanical planning, and integrates orthodontic execution using clear aligners and skeletal anchorage (temporary anchorage devices [TADs]) to achieve posterior intrusion and mandibular counterclockwise autorotation. A case example is shown that illustrates diagnosis (open bite, crowding, negative crown torque, and thin periodontal phenotype with early recessions), extraoral risk factors (gummy smile with high-lip mobility, asymmetric corridors, and lack of competent lip seal), and a digital workflow linking 2-dimensional/3-dimensional smile design to aligner planning. The treatment execution emphasized intrusion mechanics with TADs, torque control, curve-of-Spee management, and preservation of the anterior vertical position given the high display risk. Periodontal soft-tissue augmentation using connective tissue grafting via a tunneling technique supported stability in a thin phenotype. Radiographic follow-up demonstrated intrusion without adverse root or sinus changes and an improved facial balance.